Purpose or Case Report: Arthritis in pediatric patients presents a range of diagnostic challenges, including conditions such as septic arthritis, inflammatory arthritis, idiopathic chondrolysis, toxic synovitis, Lyme arthritis, and hemophilic arthritis. These conditions often share overlapping clinical and imaging features, complicating accurate diagnosis. However, key differences in clinical presentation and imaging findings can aid in differentiation. For instance, both septic arthritis and inflammatory arthritis may present with joint pain, swelling, and limited range of motion, with ultrasound commonly revealing joint effusion. Septic arthritis is typically characterized by an acute onset, high fever, elevated white blood cell (WBC) count, and significantly increased inflammatory markers. MRI findings often include complex joint effusions, synovial thickening, and periarticular bone marrow edema, with advanced cases showing periarticular myositis or pyomyositis and osteomyelitis involvement. In contrast, inflammatory arthritis usually presents with gradual onset, low-grade fever, and minimal WBC elevation, with MRI findings of symmetric or asymmetric synovial thickening, synovial enhancement, pannus formation, and mild to none surrounding muscular or bony involvement.
This educational exhibit aims to review the epidemiology of pediatric arthritis, including septic arthritis, inflammatory arthritis, idiopathic chondrolysis, toxic synovitis, Lyme arthritis, and hemophilic arthritis. It will discuss appropriate imaging protocols and highlight key clinical and imaging features that distinguish each arthritis, enhancing diagnostic accuracy and optimizing patient management.
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